Are “My Choice” Messages Making People Sick? (2020) Hook


The idea that my health is my choice obscures the fact that health is influenced by personal choice and environment. 


“The message that ‘health depends on personal choices’ obscures the ways in which health also depends on measures that individuals generally cannot affect alone.”

Hook, C. J., & Rose Markus, H. (2020). Health in the United States: Are Appeals to Choice and Personal Responsibility Making Americans Sick? Perspectives on Psychological Science, 15(3), 643–664. 

Research Story:

Two researchers from Stanford University explain how the messages we get from news, social media, and government programs that “your health is up to you” actually backfire.

The culture of personal choice in isolation fails us. When a person’s health is 100% their choice, we ignore food policies, portion sizes, availabliity of fast food, amount of sugar and salt in processed foods, and laws that could save lives. We blame illness on poor choices and stigmatize overweight people, even though the change in enviroment is often equally to blame. We expect people who want to be healthy to master complex nutritional information, sort through conflicting advice, get overwhelmed by the quantity of choices, and choose healthy foods in the face of advertising, restuarant portion sizes, shelf space for healthy versus unhealthy foods, the abundance of fast food, and candy or chips at the check-out line of not only grocery stores, but almost every store and even at schools. 

Industries like the free choice message because they don’t want legislation. Healthy policies eat into the profits of food companies.

Based in research, they recommend four narratives that need to change. 

Health depends on more than personal choice. You’re responsible for your own health and environment matters. Millions of people didn’t just suddenly decide to eat badly and create the obesity epidemic. Public policy, food companies, and the nation’s food environment changed.

Your health affects more than just you. The “my health is my business” message doesn’t take in to account insurance costs of care, the social example and impact, or how illness or death affects family and friends.

People can influence norms, change their own environments, and advocate for policy changes. Think of yourself as a social influencer with friends, family and social media to change the narrative that health is only personal choice. It’s also the choices available in the environment.

People think policy changes won’t be passed and won’t be accepted with outcries of the government being a nanny. However, laws like unleaded gas and paint, eliminating trans fats, requiring seatbelts and highway speed limits save lives and are now commonly accepted as normal. There are dozens of laws and policies that could save more lives. 

So What – Application

If the message that health is my choice is lowering health, there are a few things we can do.

1. Remind people health is about choice and environment.

2. Realize and promote the idea that your choices affect more than you (2nd hand smoke, herd immunity, loss for family if you get ill or die).

3. Try to change the environment (personal and policy).

4. Have faith that people will support healthy policy changes (seat belt laws, no smoking on airplanes, etc.)